Friday, 9 March 2012

48 hours to save the NHS, and the Lib Dems.

I know many of my Lib Dem friends dislike Polly Toynbee but I think her article in today's Guardian and their editorial do sum up how important the events in Gateshead over the next 48 hours will be for the future of the NHS and the Lib Dems as a political party.

Toynbee says
Two NHS motions compete at the Lib Dem conference in Gateshead this weekend. Shirley's name is on the one calling for support of the bill that she has so eloquently opposed until now. The other motion, from DrEvan Harris and GP Charles West, seeks to stop it altogether. Shirley's will argue that concessions have effectively removed commercialisation – see her letter. Harris's view, backed by the medical profession, is that the legal duty on commissioners to promote competition remains red in tooth and claw (detailed in his Political Science blog). Will the party rebel as it did before or will her assurances convince? Only half an hour on Sunday has been set aside for this debate, yet that half hour may set the fate of this party, if it abandons this last chance to stop the bill........ 
Plenty of decent Lib Dems went into this coalition, Vince and Shirley among them, but how will they emerge? Claims of minor mitigation are no excuse for all they have voted for. There is a breaking point between a party and supporters that can never be repaired. When, in a year or so, the NHS is in deep disarray with waiting lists soaring, the party will wish it could boast of having voted down the NHS bill in Gateshead this weekend.
The editorial says
 But the party must now recognise that the other side has ratted on the deal that it reasonably thought it had done. There have been worthy advances on public health, but the welcome change of tone on markets was not satisfactorily reflected in the bill. Yes, there was some widening of Monitor's remit, and more recently the restoration of the legal duties on the secretary of state. On closer reading, however, many changes were not what they seemed. Rather like a pompous individual who says "not unlike" when "like" would do, the bill's new mandate for Monitor to "prevent anti-competitive practices" adds syntax without changing the underlying thought. If you doubt the basic continuity, just read the defiant defence of the competitive thrust of the reforms which Mr Lansley recently penned for Health Service Journal; there he compared the nascent market in medicine to that in electronic goods. Lib Dems may half-believe and half-hope that they have changed the design, but the architect himself smiles on with satisfaction as he watches the foundation stones fall into place, exactly where he wants them.....
Delegates may be told that the tweaked bill represents the best deal they could get. Contemptuous Tories, who mutter that with a sixth of the MPs their partners are ripe for cutting down to size, will be thrilled by such talk. The truth is that there were two Lib Dem voters for every threeConservatives in 2010, and the Tories cannot rule alone. If the Lib Dem voice speaks loud and clear, it will count. There may also be claims that it is simply too late say no. Don't believe it. Officials know it's not done until it hits the statute book, so have developed plans B and C. It may even be said that the Lords cannot halt a bill on third reading. In fact, though it has not been done for a while, it is perfectly allowed.

To be clear my first thought in all of this is to protect the NHS but as a life long Liberal I am also concerned by the fate of the party. I do not want an NHS where my GP's first thought is about maximising his profits rather than patient care or my local A&E is run by Halliburton. Although Labour have a lot to answer for in beginning this competition mantra, the NHS over the last few years has reached record levels of satisfaction and is one of the most cost effective health services in the world. If it ain't broke don't fix it. Dr Evan Harris, a former Lib Dem MP has been one of the leaders of the opposition to the bill, he says
...after the so-called "listening exercise", the government made the bill much worse by requiring GPs to promote both choice (and thus competition) and "innovation" above tackling the deep-seated problems of unfair access to healthcare and gross disparities in health outcomes. No Liberal Democrat should support a bill with that order of priority. So while Lib Dem peers have won important concessions, especially in the area of competition law, and while the bill now contains requirements designed to preserve integrated care, it still goes well beyond the coalition agreement...... 
Unless there are more last-minute changes to deliver what the party required, at this weekend's party conference I urge Lib Dems to call for the plug to be pulled on this legislation – for the sake of the NHS.
In a recent poll 57% of Lib Dem members  came out against the Bill and three quarters said it would damage the party's electoral chances, while only 11% of those that voted Lib Dem at the last election support it. Personally I am unaware of any Lib Dem who is in favour of this bill and I know many who are against, a good few of whom will be supporting Winchester Lib Dems motion to ditch the Bill. The membership of the party has been in serious decline over the last year, and many like me have stopped being active. There have been a few high level resignations already, including one of the most knowledgeable and influential figures on the NHS and I am sure that if the party is instrumental in getting this bill on to the statute books many more will resign or sit on their hands. No amount of patronising guff from Clegg or Tim Farron will change that. Going into future elections as the party that saved the NHS or the party that privatised it, will, in my opinion, be the difference between survival or oblivion. 

So my voting colleagues have a total win/win. Vote for the "Withdrawal of the Health & Social Care Bill" to be the emergency motion chosen for debate and then vote for it in the debate, thereby hopefully saving the NHS and the party!


  1. Dear Grumpy , I could give a stuff about the future of the Libdems but I do care about the future of the NHS. I do believe that it delivers a good service but could (must for the future) be done more efficiently. I don't believe that doctors or public sector managers are good at managing efficiency . I do believe that the health secretary should be accountable for the service and its costs. What do you recomnend

  2. Neil, I understand your point, and the last thing the NHS needs from an efficiency point of view is yet another overwhelming re-organisation. I don't necessarily agree with your generlaisation about public sector managers, but it cannot be beyonfd the whit of man to say no more fundamental re-organisation but we want major efficiency drives at all levels of the NHS. I'm sure this could be done by pooling the best managers as internal efficiency consultants.

    If you want more detail, John Pugh MP has some ideas here.